PATNA: Going for a pathological test? You are in for trouble. For, results can vary from lab to lab. TOI learned it the hard way.
This reporter, in his pink of health, went for consultation with a doctor in a nursing home on Exhibition Road and faked so many health complications. The MBBS doctor examined the 'patient', looked a bit confused and prescribed quite a few pathological tests.
At a well-known a diagnostic lab at Kankarbagh, `pathologists' collected blood and urine samples. So did the `pathologists' of another lab at Makhania Kuan and yet another lab on Frazer Road.
Came the reports and lo and behold, they all varied from one another. One reported the haemoglobin at 76.8%, another at 70.55% and the other at 74.9%. Ditto with WBC count __ 13,200, 9,700 and 8.03%. Serum sodium level too varied __ at 138, 127 and 141.3 mEq/L. So did serum potassium level __ at 3.8, 4.21 and 3.4 mEq/L.
Worse, one lab report, prepared manually, put the sodium count in potassium column and vice versa. When pointed out, the pathologist just picked up the pen and drew two arrow marks, indicating the error.
Having pored over the reports, medical experts were not amused. "Even though the variations are not glaring enough, it's true that many of the labs operating in Bihar do not have proper expertise and equipment for undertaking such investigations," one doctor confessed as he underlined the need for government activism to rein in those who are "playing with human lives".
A senior PMCH doctor said he quite often comes across pathological reports which he finds risky to rely on. "Seasoned doctors can diagnose, to a certain extent, the malaise afflicting a patient. And they naturally feel a lack of confidence when pathological reports clash with clinical findings," he said.
Ironically, many doctors use this excuse to recommend a lab while prescribing a test to a patient. However, skeptics describe this as a "tie-up" driven by considerations other than fondness for accurate findings.
A patient had recently an ugly, verbal duel with a doctor after he refused to accept the patho report. "The doctor refused to accept the report because we got the tests done in a lab not recommended by him," said the patient's attendant, Pramod Singh.
According to Indian Medical Association (IMA)'s executive secretary Dr Arun Kumar Thakur, IMA has not issued specific guidelines for opening pathological labs. "It is generally opened by a certified pathologist," he said.
Dr Thakur, however, did not deny that several labs, though opened by certified pathologists, were being run by under-trained technicians while pathologists were busy pursuing other passions.
State health official Madan Kumar, who retired recently, feels there should be a regulatory body for pathological labs. "A functional regulatory body will boost popular confidence in the medicare available to people," he told TOI.
What to speak of a regulatory body, the state health department has virtually no control over the pathological labs. "There are certain vague guidelines," State Health Society's director-in-chief R N Pandey told this paper before he retired recently.
While the general norm is that the lab should be opened and run by a qualified pathologist, there are no guidelines on the infrastructure. "There are many labs, opened by pathologists and run by untrained technicians. I have also come across variations in findings," Pandey said and termed the "medical malpractice" as "criminal".
According to Pandey, civil surgeons have powers to conduct raids at such places and file criminal cases against erring labs. Asked how many such raids are conducted, he admitted there was lack of initiative.
"But it amounts to violation of human rights if a person gets a misleading lab report on the functioning of his organs," fumed State Human Rights Commission chairman SN Jha as he stressed that pathological reports must be prepared with "500% attention".
What rights? Lab owners care a toss about the patients' rights and laugh all the way to the bank!
Alok K N Mishra can be contacted at 9234629956.
This reporter, in his pink of health, went for consultation with a doctor in a nursing home on Exhibition Road and faked so many health complications. The MBBS doctor examined the 'patient', looked a bit confused and prescribed quite a few pathological tests.
At a well-known a diagnostic lab at Kankarbagh, `pathologists' collected blood and urine samples. So did the `pathologists' of another lab at Makhania Kuan and yet another lab on Frazer Road.
Came the reports and lo and behold, they all varied from one another. One reported the haemoglobin at 76.8%, another at 70.55% and the other at 74.9%. Ditto with WBC count __ 13,200, 9,700 and 8.03%. Serum sodium level too varied __ at 138, 127 and 141.3 mEq/L. So did serum potassium level __ at 3.8, 4.21 and 3.4 mEq/L.
Worse, one lab report, prepared manually, put the sodium count in potassium column and vice versa. When pointed out, the pathologist just picked up the pen and drew two arrow marks, indicating the error.
Having pored over the reports, medical experts were not amused. "Even though the variations are not glaring enough, it's true that many of the labs operating in Bihar do not have proper expertise and equipment for undertaking such investigations," one doctor confessed as he underlined the need for government activism to rein in those who are "playing with human lives".
A senior PMCH doctor said he quite often comes across pathological reports which he finds risky to rely on. "Seasoned doctors can diagnose, to a certain extent, the malaise afflicting a patient. And they naturally feel a lack of confidence when pathological reports clash with clinical findings," he said.
Ironically, many doctors use this excuse to recommend a lab while prescribing a test to a patient. However, skeptics describe this as a "tie-up" driven by considerations other than fondness for accurate findings.
A patient had recently an ugly, verbal duel with a doctor after he refused to accept the patho report. "The doctor refused to accept the report because we got the tests done in a lab not recommended by him," said the patient's attendant, Pramod Singh.
According to Indian Medical Association (IMA)'s executive secretary Dr Arun Kumar Thakur, IMA has not issued specific guidelines for opening pathological labs. "It is generally opened by a certified pathologist," he said.
Dr Thakur, however, did not deny that several labs, though opened by certified pathologists, were being run by under-trained technicians while pathologists were busy pursuing other passions.
State health official Madan Kumar, who retired recently, feels there should be a regulatory body for pathological labs. "A functional regulatory body will boost popular confidence in the medicare available to people," he told TOI.
What to speak of a regulatory body, the state health department has virtually no control over the pathological labs. "There are certain vague guidelines," State Health Society's director-in-chief R N Pandey told this paper before he retired recently.
While the general norm is that the lab should be opened and run by a qualified pathologist, there are no guidelines on the infrastructure. "There are many labs, opened by pathologists and run by untrained technicians. I have also come across variations in findings," Pandey said and termed the "medical malpractice" as "criminal".
According to Pandey, civil surgeons have powers to conduct raids at such places and file criminal cases against erring labs. Asked how many such raids are conducted, he admitted there was lack of initiative.
"But it amounts to violation of human rights if a person gets a misleading lab report on the functioning of his organs," fumed State Human Rights Commission chairman SN Jha as he stressed that pathological reports must be prepared with "500% attention".
What rights? Lab owners care a toss about the patients' rights and laugh all the way to the bank!
Alok K N Mishra can be contacted at 9234629956.
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